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  • Title: Flicker sensitivity and fundus appearance in pre-exudative age-related maculopathy.
    Author: Mayer MJ, Ward B, Klein R, Talcott JB, Dougherty RF, Glucs A.
    Journal: Invest Ophthalmol Vis Sci; 1994 Mar; 35(3):1138-49. PubMed ID: 8125725.
    Abstract:
    PURPOSE: To evaluate whether foveal flicker sensitivity and fundus appearance are good predictors of exudative age-related maculopathy (ARM) when the effects of aging, retinal illuminance, and criterion differences are controlled. METHODS: Fellow eyes of monocular exudative ARM patients were tested at baseline. Seven of these eyes have now developed exudative ARM. Therefore, at baseline they were in pre-exudative stages of ARM. The foveal flicker sensitivity and fundus appearance of the pre-exudative and nonconverted eyes were compared with healthy, age-matched eyes. The flicker stimulus was a uniform, 2.8 deg circular field at 660 nm, modulated sinusoidally at frequencies from 2.5 to 50 Hz. Fundus photographs were evaluated using the Wisconsin ARM grading system. RESULTS: Flicker modulation sensitivity at two frequencies discriminated pre-exudative from healthy older eyes with 100% accuracy. Using the same criterion, pre-exudative eyes also were discriminated from nonconverted eyes with 100% accuracy. Whereas an overall fundus ARM risk score discriminated pre-exudative from healthy older eyes with 100% accuracy, it did not discriminate pre-exudative from nonconverted eyes at better than chance levels. CONCLUSIONS: There were functional changes in the retina preceding development of exudative ARM. Foveal flicker sensitivity at low- to mid-temporal frequencies seemed highly sensitive to these pre-exudative changes in this relatively small group of subjects. The authors hypothesize that foveal flicker sensitivity is a good predictor of exudative ARM and a sensitive monitor of retinal function in pre-exudative ARM. These predictions are being tested on a larger, independent sample.
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